DHB clashes with union over stretched Palmerston North ED

Source: 1News

An executive at MidCentral DHB says there is disappointment Palmerston North Hospital’s emergency department (ED) was put on notice to address unsafe levels of staffing, an overcrowded noisy work environment and stressed staff.

Emergency Department, file.

The New Zealand Nurses Organisation (NZNO) said in a statement that it issued three provisional improvement notices (PINs) to Palmerston North Hospital’s emergency department on Wednesday.

The PINs recommended improvements include, among other things: closure of outpatient clinics; cancellation of elective surgeries; review of overflow bed practices, decreased visitor numbers, roster reviews and additional medical cover overnight.

The NZNO statement said safety concerns have been raised repeatedly with MidCentral District Health Board (DHB) over the last few months, but the health and safety representatives (HSRs) say concerns have not been adequately addressed.

Managers have a week to address the issues identified.

HSR Kirsten Caves says it is extremely unsafe for both patients and staff if they continue working under these circumstances.

"We’re stretched physically, mentally, and emotionally with a high level of sick leave leading to high resignations. This now means we are significantly understaffed.

"To make matters worse, we are lacking in resources and our department space just isn’t sufficient for the number of patients coming into ED."

But MidCentral DHB’s operational executive, acute and elective specialist services Lyn Horgan disagreed with the move, saying issues were already being addressed.

READ MORE: Nurses warn more lives at risk if staffing crisis not addressed

“The main issue we are trying to improve is patient flow. To manage the needs of our community, we have been running an additional all day Saturday acute theatre list, which is helping improve the flow of acute surgical patients and reduce deferred planned care surgeries.

“We have established and recruited into a number of new roles that will help support ED patients moving through our system. These include our new complex discharge specialty clinical nurse (helping coordinate discharge care for patients with complex needs), and our patient at risk service (helping identify patients who need early intervention).

“We have also seen great results from recent recruitment campaigns into ED nurse roles, and these efforts will continue.”

Horgan said MidCentral DHB takes the safety of its staff and patients very seriously.

"Over the last few months, we have engaged with staff at various levels in developing agreed action plans and implementing initiatives to alleviate these pressures.

“MidCentral DHB is disappointed with the notices given as we have seen high levels of engagement and support for our current initiatives, and this was supported by our workforce.”

ED under pressure

Horgan did acknowledge Palmerston North Hospital’s ED was under pressure.

“Like many emergency departments around the country, MidCentral DHB is seeing higher presentations at Palmerston North Hospital emergency department, with increased illnesses due to winter, as well as Covid-19. We are also seeing an increase in staff illness due to seasonal sickness and Covid-19 leave for staff or their whānau.

“Our wait times continue to be impacted by our ability to move patients into acute inpatient beds within the hospital. This is significantly limited at the moment with one ward being dedicated for Covid-19 patients and their isolation needs."

She said the discharging of some patients has taken longer as patients require increased Covid-19 clearance and/or specific support structures, including home isolation.

Horgan says there are a number of conversion and building projects ongoing.

Health Minister under fire

The Health Minister says dining in remains a risk for the spread of Covid-19.

Health Minister, Andrew Little is under increasing fire over wait times at emergency departments.

“You do have a minister that professes that there's nothing wrong, how can anybody take that seriously - first of all the Government has to acknowledge there is a crisis,” NZNO president Keri Nuku says.

But Little says the health system isn’t buckling.

“I know there are individual hospitals that are facing very, very serious pressures, the system as a whole I think is coping,” Little told 1News.

But it comes as Auckland’s Middlemore Hospital opened an urgent investigation following the death of a patient who'd left ED because of a long wait, then returned with a massive brain bleed.

“We don't know the facts around that particular case, what we do know is some hospitals are under pressure, very significant pressure actually, especially in the case of Middlemore Hospital,” Little said.

“We knew before this winter season there would be pressure because of flus and the ongoing presence of Covid and relatively high absenteeism.”